NPI | 1235834987 |
---|---|
Former Name | LAUREN FULMORE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11035610) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NH 090725-23) |
Enumeration Date | 2023-04-03 |
Last Update Date | 2024-12-20 |